DR. PHILIP LARKIN JACKSON III (NPI# 1811350705) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811350705 |
| Entity Type | Individual |
| Full Name | DR. PHILIP LARKIN JACKSON III |
| Credential | M.D. |
| Practice Address |
211 E Ontario St Suite 200 Chicago IL 60611-3468 |
| Practice Telephone | 3125037975 |
| Practice Fax Number | 3125035230 |
| Mailing Telephone | 3125037975 |
| Mailing Fax Number | 3125035230 |
| Enumeration Date | 2016-03-30 |
| Last Update Date | 2020-10-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 01083406A | IN | Allopathic & Osteopathic Physicians |
| N | 207P00000X | Emergency Medicine | 125068736 | IL | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | IL | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437174638 | Philip Jackson | Pediatrics | 2500 Hamlin Dr, Inkster, MI 48141-2348 | 2006-07-12 |
| 1780836437 | Philip Morgan Jackson | Social Worker | 220 Danville Corner Rd, Auburn, ME 04210-8605 | 2008-10-14 |
| 1790963916 | Philip Rodney Jackson | Dentist | 3790 Fernandina Rd, Suite 201, Columbia, SC 29210-3864 | 2008-02-11 |
| 1306852678 | Philip C Jackson Jr. | Internal Medicine | 1301 W 38th St #205, Austin, TX 78705-1011 | 2006-07-31 |
| Street Address |
211 E ONTARIO ST SUITE 200 |
| City | CHICAGO |
| State | IL |
| Zip Code | 60611-3468 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891773321 | Theodore Kypreos Koutouzis | Emergency Medicine | 211 E Ontario St, Chicago, IL 60611-3468 | 2006-01-05 |
| 1326401290 | Jordan Maivelett | Emergency Medicine | 211 E Ontario St, Suite 200, Chicago, IL 60611-3468 | 2016-03-30 |
| 1306208517 | Kumar Rajesh Gandhi | Emergency Medicine | 211 E Ontario St, Suite 200, Chicago, IL 60611-3468 | 2016-03-26 |
| 1598127896 | Vidya Eswaran | Emergency Medicine | 211 E Ontario St, Suite 200, Chicago, IL 60611-3468 | 2016-03-25 |
| 1134581739 | Luke Neill | Emergency Medicine | 211 E Ontario St, Suite 200, Chicago, IL 60611-3468 | 2016-03-23 |
| 1487040523 | Steve Chukwulebe | Emergency Medicine | 211 E Ontario St, Suite 200, Chicago, IL 60611-3468 | 2015-04-14 |
| 1336535921 | Andrew Berg | Emergency Medicine | 211 E Ontario St, Suite 200, Chicago, IL 60611-3468 | 2015-04-09 |
| 1982099651 | Katharine Rose Colton | Emergency Medicine | 211 E Ontario St, Suite 200, Chicago, IL 60611-3468 | 2015-03-31 |
| 1295129195 | William J Ford | Emergency Medicine | 211 E Ontario St, Suite 200, Chicago, IL 60611-3468 | 2015-03-27 |
| 1952795999 | Andrew Royce Cunningham | Emergency Medicine | 211 E Ontario St, Suite 200, Chicago, IL 60611-3468 | 2015-03-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861092835 | Lauren Less | Social Worker | 111 East Pearson St, Chicago, IL 60611 | 2020-10-29 |
| 1134735962 | Kalvin Cheuk Hang Lung | Student in an Organized Health Care Education/Training Program | 675 N St Clair St 17th Floor, Chicago, IL 60611 | 2020-09-17 |
| 1487267845 | Ashley Marie Sablich | Student in an Organized Health Care Education/Training Program | 250 E Huron Street, Suite 1-200, Chicago, IL 60611 | 2020-08-26 |
| 1245854033 | Danielle Humphrey | Student in an Organized Health Care Education/Training Program | Pa Program, Suite 1-200, 240 East Huron Street, Chicago, IL 60611 | 2020-06-08 |
| 1801418074 | Sana Healing Collective | Clinic/Center | 405 N. Wabash Street, Chicago, IL 60611 | 2020-05-11 |
| 1194359489 | Insight:eating Disorders, Weight Management & Psychological Centers | Psychiatric Hospital | 1 E. Erie Street, 4th Floor, Chicago, IL 60611 | 2020-02-26 |
| 1902439193 | Iwona Boska | Nurse Practitioner | 676 N St.clair Street, Suite 2140, Chicago, IL 60611 | 2020-02-17 |
| 1922643576 | Sarah Elizabeth Schwartzer | Audiologist | Chicago Dizziness and Hearing, 645 North Michigan Avenue, Suite 410, Chicago, IL 60611 | 2019-11-07 |
| 1023668852 | Anne Marguerite Davidson | Student in an Organized Health Care Education/Training Program | Mcgraw Medical Center, 240 E Huron Street, Suite 1-200, Chicago, IL 60611 | 2019-09-13 |
| 1871141085 | Coast Management | Durable Medical Equipment & Medical Supplies | 40 E. Chicago Ave, Suite 149, Chicago, IL 60611 | 2019-08-30 |
| Find all providers in zip 60611 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811503394 | Susan Lochhead | Emergency Medicine | 1930 N Fremont St, Chicago, IL 60614-5017 | 2020-09-19 |
| 1851900344 | Cepamerica Illinois PC | Emergency Medicine | 2112 S Michigan Ave, Chicago, IL 60616-1704 | 2020-07-30 |
| 1538622287 | Brandon Fen Chang | Emergency Medicine | 820 S Wood St Ste 100, Chicago, IL 60612-4325 | 2019-04-10 |
| 1053872630 | Oretunlewa Soyinka | Emergency Medicine | 5841 S Maryland Ave # 5068, Chicago, IL 60637-1443 | 2019-03-27 |
| 1457818098 | Innovative Iv Care, Pllc | Emergency Medicine | 3221 N Sheffield Ave Ste 100, Chicago, IL 60657-8510 | 2019-03-01 |
| 1013414077 | Lauran Wirfs | Emergency Medicine | 1650 W Harrison St, 466 Atrium, Rush University Medical Center, Gme, Chicago, IL 60612 | 2018-04-06 |
| 1518461987 | David Bennett Feiger | Emergency Medicine | 211 E Huron St, Suite 200, Chicago, IL 60611-3055 | 2018-03-21 |
| 1639699127 | Eugene David Hill | Emergency Medicine | 1623 N Rockwell St, Chicago, IL 60647-5217 | 2017-06-26 |
| 1740719905 | Courtney Hutchins | Emergency Medicine | 5841 S. Maryland Avenue Mc1052, J-141, Chicago, ID 60637 | 2017-06-09 |
| 1417305137 | Christopher Louis Scodeller | Emergency Medicine | 7435 W. Talcott A, Presence Resurrection Medical Center, Chicago, IL 60631 | 2016-06-03 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.